关键词: Raynaud's phenomenon cyclosporin A joint contracture methotrexate morphea profunda

Mesh : Administration, Oral Arthritis, Juvenile / diagnosis Biopsy Child Contracture / diagnosis drug therapy etiology Cyclosporine / therapeutic use Dermatologic Agents / therapeutic use Diagnostic Errors Drug Therapy, Combination / methods Female Humans Magnetic Resonance Imaging Prednisolone / therapeutic use Scleroderma, Localized / complications diagnosis drug therapy pathology Skin / diagnostic imaging pathology Treatment Outcome Wrist Joint

来  源:   DOI:10.1111/1346-8138.14801   PDF(Sci-hub)

Abstract:
Morphea profunda refers to inflammatory and sclerotic lesions that start primarily from the deep dermis, subcutaneous fat and fascia. Its pediatric case published work is limited. Here, we report the case of an 8-year-old girl with a 5-year history of multiple subcutaneous nodules on her extremities and a right wrist joint contracture who had been previously diagnosed with juvenile idiopathic arthritis and treated with salazosulfapyridine, low-dose prednisolone (PSL) and methotrexate. We performed biopsies of two subcutaneous nodules, which revealed the typical morphology of morphea profunda. She was administrated a tapered course of oral PSL then cyclosporin A (CyA) for 20 weeks which completely resolved her joint contracture and subcutaneous nodules. We reviewed 11 previously reported cases of morphea profunda and found that some include circumscribed/linear morphea that develop into subcutaneous tissues, indicating that \"classical\" morphea profunda arising within the deep tissues has rarely been reported. Our report is the first to demonstrate the efficacy of CyA for treatment of morphea profunda, and the possibility of CyA as a treatment option to reduce oral steroid doses in juvenile cases.
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